Health-related quality of life (HRQoL) is an important health indicator in chronic diseases like kidney diseases. Health literacy (HL) may strongly affect HRQoL, but evidence is scarce. Therefore, we assessed the associations of HL with HRQoL in dialysed patients. We performed a cross-sectional study in 20 dialysis clinics across Slovakia (n = 542 patients, mean age = 63.6 years, males = 60.7%). We assessed the association of categorised HL (low, moderate, high) with the SF36 physical component score (PCS) and mental component score (MCS) using generalised linear models adjusted for age, gender, education, and comorbidity (Charlson Comorbidity Index, CCI). We found significant associations of HL with PCS and MCS in dialysed patients, adjusted for age, gender, education, and CCI. Low-HL patients had a lower PCS (B = -3.27, 95%-confidence interval, CI: -5.76/-0.79) and MCS (B = -6.05, 95%-CI: -8.82/-3.29) than high-HL patients. Moderate-HL patients had a lower MCS (B = -4.26, 95%-CI: -6.83/-1.69) than high-HL patients. HL is associated with physical and mental HRQoL; this indicates that dialysed patients with lower HL deserve specific attention and tailored care to have their HRQoL increased.

2 Internal Clinic Faculty of Medicine P J Safarik University Trieda SNP 1 040 01 Kosice Slovakia

Department of Community and Occupational Medicine University Medical Center Groningen University of Groningen Antonius Deusinglaan 1 9713 AV Groningen The Netherlands

Department of Health Psychology and Research Methodology Faculty of Medicine P J Safarik University Trieda SNP 1 040 01 Kosice Slovakia

FMC Dialysis Services Slovakia Trieda SNP 1 040 01 Kosice Slovakia

Graduate School Kosice Institute for Society and Health Faculty of Medicine P J Safarik University Trieda SNP 1 040 01 Kosice Slovakia

Institute of Applied Psychology Faculty of Social and Economic Sciences Comenius University Bratislava Mlynské luhy 4 821 05 Bratislava Slovakia

Institute of Mathematics Faculty of Science P J Safarik University Jesenna 5 040 01 Kosice Slovakia

Olomouc University Social Health Institute Palacky University Univerzitni 22 771 11 Olomouc Czech Republic

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